Individual provider Active NPI

Sarah Elizabeth Clark, PA-C

  • Physician Assistant
  • Lewes, DE
National Provider Identifier
1851995310
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C5-0011450 Issued in DE
Practice address
18068 Coastal Hwy
Lewes, DE 19958-4901
Phone
(302) 567-1500
NPI assigned
Nov 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C5-0011450 DE Primary

Addresses

Primary practice location

18068 Coastal Hwy
Lewes, DE 19958-4901

Mailing address

90 Sandtown Rd
Felton, DE 19943-2501

Other names 1

  • Sarah Elizabeth Russo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210318000180 DE Practitioner - Physician Assistant 8022425024 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Atracare Walk-in LLC 20 clinicians

Practice addresses (Care Compare)

18068 Coastal Hwy
Lewes, DE 19958-4901
Phone (302) 567-1500

Hospital & facility affiliations

  • Beebe Medical Center Hospital, Lewes, DE, CCN 080007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Christiana Care Quality Partners PastSince Aug 1, 2021 Accepting new patients
Bayhealth Emergency Physicians LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: sarah.clark.1@22424.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1606262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1851995310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 SANDTOWN RD",
            "city": "FELTON",
            "state": "DE",
            "postal_code": "199432501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18068 COASTAL HWY",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199584901",
            "telephone_number": "302-567-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-25",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0011450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "RUSSO",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lewes, DE

Sources for this page

Verify at the official NPI Registry.